探讨氯吡格雷药物代谢相关基因CYP2C19多态性对冠心病经皮冠状动脉介入治疗术后患者预后的影响

Study on Effect of Clopidogrel Drug Metabolism Related Gene CYP2C19 Polymorphism on the Prognosis of Patients after the Percutaneous Coronary Intervention for Coronary Heart Disease

目的探讨氯吡格雷药物代谢相关基因CYP2C19多态性对冠心病经皮冠状动脉介入治疗(PCI)术后患者预后的影响。方法选取2015年12月—2017年12月期间于该院住院治疗的冠心病患者120例,检测患者CYP2C19基因型并进行为期6个月的随访。结果 120例患者中PM型患者13例(10.83%);IM型患者56例(46.67%);EM型患者50例(41.67%);1例(0.83%)检测结果为阴性,无法判断其类型。其中CYP2C19*1的频率为65.20%;CYP2C19*2频率为26.6%、CYP2C19*3频率为6.60%。携带功能缺失型等位基因组的MACE发生率明显高于EM组,差异有统计学意义(χ~2=10.115,P<0.05)。糖尿病及CYP2C19基因型别与MACE发生有相关性,差异有统计学意义(OR=14.52、24.65,P<0.05)。结论长期服用氯吡格雷的冠心病PCI术后患者预后与其CYP2C19基因型别有关,至少携带一种功能缺失型基因的患者MACE发生率显著高于野生型基因患者。

Objective To study the effect of clopidogrel drug metabolism related gene CYP2C19 polymorphism on the prognosis of patients after the pereutaneous coronary intervention for coronary heart disease. Methods 120 cases of pa tients with eoronary heart diseases for hospitalization treatment in our hospital from December 2015 to December 2017 were selected, and the patients were for 6-month follow-up. Results Of 120 cases of patients, there were 13 cases （10.83%） in PM type, 56 cases in IM type （46.67%） , 50 cases in EM type, （41.67%） , the test result of 1 ease was negative （0.83%） , and the frequency of CYP2C19＊I was 65.20%, and the frequency of CYP2C19＊2 was 26.6%, the frequency of CYP2C19＂3 was 6.60%, and the incidence rate of MACE was obviously higher than that in the EM group, and the difference was statistically significant （χ2=10.115, P〈 0.05） , and the diabetes and CYP2C19 gene type was ton＇elated with the occurrence of MACE, and the difference was statistically significant （OR=14.52, 24.65, P〈 0.05） . Conclusion The prognosis of patients with long-term administration of elopidogrel drugs after the coronary heart dis ease PCI surgery is related to its CYP2C19 gene type, the incidence rate of MACE of patients with at least afunction gene is obviously higher than that of patients with wild-type gene.